This evening I attended my first meeting as a member of the Sarasota Manatee Chapter of the National Organization for Women. Of course, I have known about this trailblazing group since my adolescence, but became more deeply interested when planning Maternal Health Care in the 21st Century with one of NOW's founders, Sonia Pressman Fuentes. I decided to join today because of their discussion topic: What do today's young mothers want?
After the chapter's business was addressed, the discussion began. Group facilitator Judy Helgager honored the month of Mother's Day by bringing the needs of young mothers to NOW's table, with the intent to discuss ideas to attract this demographic into NOW membership. To prepare, Judy visited several popular "Mommy Blogs" prior to the meeting and read up on what issues were important to young mothers today.
Judy concluded that today's young mothers want to be valued. They want to stay home with their children and earn an income at the same time. They want their voices to be heard.
One of the reasons I was so excited to co-plan last year's panel discussion on maternal health with one of NOW's founders is that I have long found interesting the dichotomy of reproductive rights efforts within the feminist arena. While feminist groups have made great strides in related issues (currently the chapter is very active against H.B. 983), the right of a woman to give birth where, how, and with whom she chooses has largely been a non-issue.
I would argue in the context of tonight's discussion that one way to attract young mothers to feminist groups is by conveying the message that the right to transparent information about childbirth in this country is important. That women should be able to give birth naturally in a hospital if they so choose, without fear of unwanted intervention. That women can give birth at home with a licensed midwife and be within their legal rights and insurance network. That risks and benefits of common interventions be clearly discussed in public forums. That women will be supported before, during and after the births of their children. That groups such as NOW will communicate with elected officials about the high number of America's c-sections (42% in Sarasota)--many of which, data shows, are unwanted--and our absolutely unacceptable maternal mortality rates (currently 41st in the world).
For mothers, birth transforms women like no other single event in their lives. This singular event has the ability to empower a woman or traumatize her. The right to a healthy, informed, supported and conscious birth is the ultimate woman's right. These are the Rights of Childbearing Women, as produced by Childbirth Connection:
1. Every woman has the right to health care before, during and after pregnancy and childbirth.
2. Every woman and infant has the right to receive care that is consistent with current scientific evidence about benefits and risks. Practices that have been found to be safe and beneficial should be used when indicated. Harmful, ineffective or unnecessary practices should be avoided. Unproven interventions should be used only in the context of research to evaluate their effects.
3. Every woman has the right to choose a midwife or a physician as her maternity care provider. Both caregivers skilled in normal childbearing and caregivers skilled in complications are needed to ensure quality care for all.
4. Every woman has the right to choose her birth setting from the full range of safe options available in her community, on the basis of complete, objective information about benefits, risks and costs of these options.
5. Every woman has the right to receive all or most of her maternity care from a single caregiver or a small group of caregivers, with whom she can establish a relationship. Every woman has the right to leave her maternity caregiver and select another if she becomes dissatisfied with her care. (Only second sentence is a legal right.)
6. Every woman has the right to information about the professional identity and qualifications of those involved with her care, and to know when those involved are trainees.
7. Every woman has the right to communicate with caregivers and receive all care in privacy, which may involve excluding nonessential personnel. She also has the right to have all personal information treated according to standards of confidentiality.
8. Every woman has the right to receive maternity care that identifies and addresses social and behavioral factors that affect her health and that of her baby. She should receive information to help her take the best care of herself and her baby and have access to social services and behavioral change programs that could contribute to their health.
9. Every woman has the right to full and clear information about benefits, risks and costs of the procedures, drugs, tests and treatments offered to her, and of all other reasonable options, including no intervention. She should receive this information about all interventions that are likely to be offered during labor and birth well before the onset of labor.
10. Every woman has the right to accept or refuse procedures, drugs, tests and treatments, and to have her choices honored. She has the right to change her mind. (Please note that this established legal right has been challenged in a number of recent cases.)
11. Every woman has the right to be informed if her caregivers wish to enroll her or her infant in a research study. She should receive full information about all known and possible benefits and risks of participation; and she has the right to decide whether to participate, free from coercion and without negative consequences.
12. Every woman has the right to unrestricted access to all available records about her pregnancy, labor, birth, postpartum care and infant; to obtain a full copy of these records; and to receive help in understanding them, if necessary.
13. Every woman has the right to receive maternity care that is appropriate to her cultural and religious background, and to receive information in a language in which she can communicate.*
14. Every woman has the right to have family members and friends of her choice present during all aspects of her maternity care.
15. Every woman has the right to receive continuous social, emotional and physical support during labor and birth from a caregiver who has been trained in labor support.
16. Every woman has the right to receive full advance information about risks and benefits of all reasonably available methods for relieving pain during labor and birth, including methods that do not require the use of drugs. She has the right to choose which methods will be used and to change her mind at any time.
17. Every woman has the right to freedom of movement during labor, unencumbered by tubes, wires or other apparatus. She also has the right to give birth in the position of her choice.
18. Every woman has the right to virtually uninterrupted contact with her newborn from the moment of birth, as long as she and her baby are healthy and do not need care that requires separation.
19. Every woman has the right to receive complete information about the benefits of breastfeeding well in advance of labor, to refuse supplemental bottles and other actions that interfere with breastfeeding, and to have access to skilled lactation support for as long as she chooses to breastfeed.
20. Every woman has the right to decide collaboratively with caregivers when she and her baby will leave the birth site for home, based on their conditions and circumstances.
So...what do today's young mothers want? We want to be supported, valued and empowered with the knowledge that we have the most evidence-based information by which to make autonomous decisions about the health of ourselves and our children. It takes a village to raise a child. It also takes a village to raise a mother. It's time our country acted as our village and gave our mothers a clear message: You are supported. You are valued.
I will continue to support our local chapter of the National Organization for Women with the optimism that the tremendous leaps they have made will now translate to efforts to empower birthing women. I urge all mothers in my community to voice their support to this historic and powerful organization, and let them know that the right to a healthy birth is important to you.
Wednesday, May 19, 2010
BIRTH STORY: Birthing Bella Grace
(by Michelle Harmon, about the birth of Bella Grace, born 02.02.07)
I was greeted by labor contractions on Friday, February 2, 2007 – Groundhog Day. It was 2 am and I knew these weren’t Braxton Hicks contractions because they were considerably stronger than what I had been experiencing throughout the week. I didn’t want to wake Hal up, though, because they didn’t feel “strong enough” to warrant his groggy I-need-a-cup-of-coffee support. I fell asleep between each contraction – they were about 15-20 minutes apart. At 5 am, I needed to get out of bed to take a shower and “get ready” for labor. Tisk, tisk. I should have known better.
After my shower I woke Hal up and told him, this is it. I am in labor. He phoned into work to start his MONTH long vacation. We sat out in the living room together, ate breakfast, drank our coffee and wondered what the heck we should do. After Max woke up and finished his breakfast we called Hal’s mom to let her know she could come pick Max up. We had previously decided that Max wasn’t ready to witness such an intense event. My contractions were still regular and feeling strong but not increasing in intensity.
Saying “see you after Bella is born” to Max:
I called everyone around 8:30am, to let them know what was going on. Of-course, my midwife was sleeping so I basically woke her up to let her know, um, that she should go back to sleep because I was in labor. I felt bad because I also woke her up when I was in labor with Max to tell her something similar. I have a feeling this probably happens a lot to midwives – the eager laboring woman who prematurely calls to give a “heads up.”
Hal and I couldn’t decide if we should labor by ourselves or call our doula, Nancy, for the support we so desperately needed. Funny, although I totally trust my body to give birth I still need someone there to “look after” my well being. We called Nancy and she was there by 9:30am.
This labor was already much different than my labor with Max. With Max, I went into labor at 4 pm and progressed rather rapidly. With Bella, I seemed to be stuck in a space that went on for infinity. My contractions were strong enough to demand my full attention when they arrived but as soon as they passed, I was laughing and talking like it were any ol’ day. With Max, I couldn’t even form a thought between contractions.
Yay! For the birth ball!
I laughed so hard while in labor with Bella! Nancy was awesome. Hal and I felt so at ease with her and at one point when I thought I was putting her out because I hadn’t started pushing she assured me that she was excited to be there and wanted to be there. I felt so comfortable with her. I knew that if I wanted her to leave I could ask and it wouldn’t be awkward. I also felt that if *she* needed to leave, she would have.
I labored with Hal and Nancy all day. I held onto Hal during the contractions while Nancy did the double-hip-squeeze on my lower back. I used the birthing ball for almost every contraction. I also did quite a few leg lunges to open up my pelvic bones. I ate a lot, we baked a cake (and ate some of that, too), talked, and laughed. At one point, Hal and I danced to Lady Sovereign. Labor was pretty consistent all day.
Dancing to Lady Sovereign:
As an effort to help kick the contractions up a notch, Hal and I took a walk around the neighborhood. It was a pretty short walk because I was in a lot of pain. When we got back to the house I laid down to rest. After waking from my little nap I took a shower and the contractions seemed a lot more intense. Nancy called Heidi to let her know. Heidi made her way over to our house.
When Heidi arrived around 6:30 pm and assessed the situation, I asked her to check me to see how far I’d dilated. I could hardly believe that I labored all day long. During the morning hours Hal, Nancy, and I were so sure that I would have pushed that baby out by noon! I was 5-6 cm dilated when Heidi checked me.
Things get a little fuzzy around this time because the contractions started getting more intense. I remember Heidi giving me the antibiotics for GBS. I also found out that she had forgotten the labor pool. I was so upset because I really wanted to get in that pool of warm water. She called the other midwife and her assistant to let them know they had to pick up a pool. It seemed to take forever for them to get to the house.
Finally, they called and said they were lost. At this point I must have been 7-8 cm dilated. In between contractions I gave them directions to my house. I was still laughing and joking around. We all thought it was funny that the laboring mama was giving directions. When they arrived with my pool they quickly set it up and I eagerly slid in.
Giving Directions:
It felt like I was taking too long to get to the pushing stage and that really pissed me off. I found myself getting irritable with my midwife and her staff. I started crying during and between the contractions saying that I wasn’t going to make it, I couldn’t do this any more and I needed drugs. I was getting annoyed because my midwife’s two assistants were too loud in my kitchen. And I got pissed at my midwife for yawning too loudly. Hal, Nancy, and Liz (who arrived around 8:30pm) were the only people I needed and as far as I was concerned, everyone else could have left. Anyway, I was grouchy – but I didn’t really say anything to anyone about it. Hal did said that once, when someone said that I was doing great, I snapped at them and said, “stop saying that!” I vaguely remember this.
Heidi suggested that I get up out of the pool and walk around the living room. The walking turned into stomping and Heidi went from midwife to drill sergeant. I was ordered to stomp hard and when I felt the contraction coming on, stop, go through it, then get up and walk-stomp again. Heidi was stomping behind me as I went around the parameter of the living room. There were two ladies in the kitchen, Liz sat on the floor next to the dinning room table, Hal walked backwards in front of me as I held onto him, and Heidi stomped behind me. It was not fun AT ALL.
From there I think I went back in the pool, got out again, sat on the toilet for a while, back in the pool, back on the toilet – so on and so forth. I was exhausted and asked Heidi, “so when is pain relief an option?” She said, “well, your option for pain relief right now is to get back into that water.” Bitch. She knew I was close. Her answer pissed me off but I trusted her. I got back into the pool and the contractions got really intense. The pushing part followed shortly thereafter.
Earlier I had expressed that I felt like I needed to take a bowel movement. Everyone cheered after I farted my way to the toilet exclaiming, “that’s great! We love farting and pooping! It means you are getting close!” Well, I never did poop on the pot. When I started pushing in the pool I felt Bella right as rain right in my birth canal. I felt her head slip down over my rectum as I (SHE) pushed out the largest poop of my life. I swear I saw a geyser explode in the middle of that little kiddy pool. It felt so incredibly good. Hal later told me that I looked like Rocky Balboa screaming his famous line, “Adrienne!” The next thing I heard was, “um, okay, I think we are going to get you out of the pool, now.”
Heidi ordered everyone to set up the bed and help me out. I was totally out of my mind at this point and felt like this labor WOULD NEVER END. I don’t know how I did it, with everyone’s help (of-course) I got out of the pool and onto the bed. I was on the wrong bed so had to move one bed over to the one that was set up for my labor. Again, I had lots of help making this move.
I was on my back and I felt Bella move further down the birth canal as I pushed with each contraction. Even though I could feel her head, I STILL felt like I would NEVER push this baby out. I was scared, exhausted, and it felt like I was unraveling from the inside out. Everything was so surreal. Feeling her inside me was unbelievable. I was totally freaked out by it.
One of Heidi’s assistants was by my head whispering words of calming comfort into my ear. She kept me sane and focused. Liz was stationed (again!) at one leg holding it to help me push, the other assistant had my other leg, Nancy had the camera ready, and Hal and Heidi were ready to catch Bella.
This was it, I thought, I am going to finally see my baby girl! I pushed several times in a row because the contractions were right on top of one another. Harmony, the one in my ear, told me to push gently – she said that my body already knew how to get Bella out and I could just let it do all the work. I listened to her and felt calmer but still TOTALLY freaked that this was actually happening – on my bed! Max was born in the water and I hardly felt him come out. With Bella, I felt everything, right down to her crowing head moving side to side trying to help inch herself out. Her head even moved side to side when it was the only part of her body out of the birth canal! One last push and she was out. Hal put her onto my chest and thanks to my premeditated desire to say this to her when she arrived, I repeated over and over from the bottom of my heart… I love you, I love you, I love you.
I was so blissed out. My 10 pound, 22 inches of beautiful baby girl was finally birthed at 10:46pm.
I have to tell you… my midwife, Heidi, and her staff WERE AWESOME. My memories years later are much more sweet and loving. I wrote this birth story a week or so after giving birth when the memories were raw and unprocessed to the context of the situation {best way to write IMO}. BellaGrace is now three years old! And our midwife is still a part of our lives. I just think that is amazing and so special.
In hindsight, it is clear that I was just really bitchy/bitching in my head during this labor. Heidi was patient, kind, and super supportive. I was highly agitated by how long the labor was taking. My first baby was born in 12 hours, this labor was 21 hours!
I was greeted by labor contractions on Friday, February 2, 2007 – Groundhog Day. It was 2 am and I knew these weren’t Braxton Hicks contractions because they were considerably stronger than what I had been experiencing throughout the week. I didn’t want to wake Hal up, though, because they didn’t feel “strong enough” to warrant his groggy I-need-a-cup-of-coffee support. I fell asleep between each contraction – they were about 15-20 minutes apart. At 5 am, I needed to get out of bed to take a shower and “get ready” for labor. Tisk, tisk. I should have known better.
After my shower I woke Hal up and told him, this is it. I am in labor. He phoned into work to start his MONTH long vacation. We sat out in the living room together, ate breakfast, drank our coffee and wondered what the heck we should do. After Max woke up and finished his breakfast we called Hal’s mom to let her know she could come pick Max up. We had previously decided that Max wasn’t ready to witness such an intense event. My contractions were still regular and feeling strong but not increasing in intensity.
Saying “see you after Bella is born” to Max:
I called everyone around 8:30am, to let them know what was going on. Of-course, my midwife was sleeping so I basically woke her up to let her know, um, that she should go back to sleep because I was in labor. I felt bad because I also woke her up when I was in labor with Max to tell her something similar. I have a feeling this probably happens a lot to midwives – the eager laboring woman who prematurely calls to give a “heads up.”Hal and I couldn’t decide if we should labor by ourselves or call our doula, Nancy, for the support we so desperately needed. Funny, although I totally trust my body to give birth I still need someone there to “look after” my well being. We called Nancy and she was there by 9:30am.
This labor was already much different than my labor with Max. With Max, I went into labor at 4 pm and progressed rather rapidly. With Bella, I seemed to be stuck in a space that went on for infinity. My contractions were strong enough to demand my full attention when they arrived but as soon as they passed, I was laughing and talking like it were any ol’ day. With Max, I couldn’t even form a thought between contractions.
Yay! For the birth ball!
I laughed so hard while in labor with Bella! Nancy was awesome. Hal and I felt so at ease with her and at one point when I thought I was putting her out because I hadn’t started pushing she assured me that she was excited to be there and wanted to be there. I felt so comfortable with her. I knew that if I wanted her to leave I could ask and it wouldn’t be awkward. I also felt that if *she* needed to leave, she would have.I labored with Hal and Nancy all day. I held onto Hal during the contractions while Nancy did the double-hip-squeeze on my lower back. I used the birthing ball for almost every contraction. I also did quite a few leg lunges to open up my pelvic bones. I ate a lot, we baked a cake (and ate some of that, too), talked, and laughed. At one point, Hal and I danced to Lady Sovereign. Labor was pretty consistent all day.
Dancing to Lady Sovereign:
As an effort to help kick the contractions up a notch, Hal and I took a walk around the neighborhood. It was a pretty short walk because I was in a lot of pain. When we got back to the house I laid down to rest. After waking from my little nap I took a shower and the contractions seemed a lot more intense. Nancy called Heidi to let her know. Heidi made her way over to our house.When Heidi arrived around 6:30 pm and assessed the situation, I asked her to check me to see how far I’d dilated. I could hardly believe that I labored all day long. During the morning hours Hal, Nancy, and I were so sure that I would have pushed that baby out by noon! I was 5-6 cm dilated when Heidi checked me.
Things get a little fuzzy around this time because the contractions started getting more intense. I remember Heidi giving me the antibiotics for GBS. I also found out that she had forgotten the labor pool. I was so upset because I really wanted to get in that pool of warm water. She called the other midwife and her assistant to let them know they had to pick up a pool. It seemed to take forever for them to get to the house.Finally, they called and said they were lost. At this point I must have been 7-8 cm dilated. In between contractions I gave them directions to my house. I was still laughing and joking around. We all thought it was funny that the laboring mama was giving directions. When they arrived with my pool they quickly set it up and I eagerly slid in.
Giving Directions:
It felt like I was taking too long to get to the pushing stage and that really pissed me off. I found myself getting irritable with my midwife and her staff. I started crying during and between the contractions saying that I wasn’t going to make it, I couldn’t do this any more and I needed drugs. I was getting annoyed because my midwife’s two assistants were too loud in my kitchen. And I got pissed at my midwife for yawning too loudly. Hal, Nancy, and Liz (who arrived around 8:30pm) were the only people I needed and as far as I was concerned, everyone else could have left. Anyway, I was grouchy – but I didn’t really say anything to anyone about it. Hal did said that once, when someone said that I was doing great, I snapped at them and said, “stop saying that!” I vaguely remember this.Heidi suggested that I get up out of the pool and walk around the living room. The walking turned into stomping and Heidi went from midwife to drill sergeant. I was ordered to stomp hard and when I felt the contraction coming on, stop, go through it, then get up and walk-stomp again. Heidi was stomping behind me as I went around the parameter of the living room. There were two ladies in the kitchen, Liz sat on the floor next to the dinning room table, Hal walked backwards in front of me as I held onto him, and Heidi stomped behind me. It was not fun AT ALL.
From there I think I went back in the pool, got out again, sat on the toilet for a while, back in the pool, back on the toilet – so on and so forth. I was exhausted and asked Heidi, “so when is pain relief an option?” She said, “well, your option for pain relief right now is to get back into that water.” Bitch. She knew I was close. Her answer pissed me off but I trusted her. I got back into the pool and the contractions got really intense. The pushing part followed shortly thereafter.Earlier I had expressed that I felt like I needed to take a bowel movement. Everyone cheered after I farted my way to the toilet exclaiming, “that’s great! We love farting and pooping! It means you are getting close!” Well, I never did poop on the pot. When I started pushing in the pool I felt Bella right as rain right in my birth canal. I felt her head slip down over my rectum as I (SHE) pushed out the largest poop of my life. I swear I saw a geyser explode in the middle of that little kiddy pool. It felt so incredibly good. Hal later told me that I looked like Rocky Balboa screaming his famous line, “Adrienne!” The next thing I heard was, “um, okay, I think we are going to get you out of the pool, now.”
Heidi ordered everyone to set up the bed and help me out. I was totally out of my mind at this point and felt like this labor WOULD NEVER END. I don’t know how I did it, with everyone’s help (of-course) I got out of the pool and onto the bed. I was on the wrong bed so had to move one bed over to the one that was set up for my labor. Again, I had lots of help making this move.
I was on my back and I felt Bella move further down the birth canal as I pushed with each contraction. Even though I could feel her head, I STILL felt like I would NEVER push this baby out. I was scared, exhausted, and it felt like I was unraveling from the inside out. Everything was so surreal. Feeling her inside me was unbelievable. I was totally freaked out by it.
One of Heidi’s assistants was by my head whispering words of calming comfort into my ear. She kept me sane and focused. Liz was stationed (again!) at one leg holding it to help me push, the other assistant had my other leg, Nancy had the camera ready, and Hal and Heidi were ready to catch Bella.
This was it, I thought, I am going to finally see my baby girl! I pushed several times in a row because the contractions were right on top of one another. Harmony, the one in my ear, told me to push gently – she said that my body already knew how to get Bella out and I could just let it do all the work. I listened to her and felt calmer but still TOTALLY freaked that this was actually happening – on my bed! Max was born in the water and I hardly felt him come out. With Bella, I felt everything, right down to her crowing head moving side to side trying to help inch herself out. Her head even moved side to side when it was the only part of her body out of the birth canal! One last push and she was out. Hal put her onto my chest and thanks to my premeditated desire to say this to her when she arrived, I repeated over and over from the bottom of my heart… I love you, I love you, I love you.I was so blissed out. My 10 pound, 22 inches of beautiful baby girl was finally birthed at 10:46pm.
I have to tell you… my midwife, Heidi, and her staff WERE AWESOME. My memories years later are much more sweet and loving. I wrote this birth story a week or so after giving birth when the memories were raw and unprocessed to the context of the situation {best way to write IMO}. BellaGrace is now three years old! And our midwife is still a part of our lives. I just think that is amazing and so special.In hindsight, it is clear that I was just really bitchy/bitching in my head during this labor. Heidi was patient, kind, and super supportive. I was highly agitated by how long the labor was taking. My first baby was born in 12 hours, this labor was 21 hours!
Monday, May 17, 2010
Rep. Kathy Castor Calls House Subcomittee Meeting to Reduce Florida's C-Section Rate
Three cheers for U.S. Representative Kathy Castor (D-Tampa). Last Wednesday, she led a a hearing in the House Subcommittee on Health about the risks of preterm births and their direct correlation to the soaring c-section rates, saying "We have a public-health crisis. Our rates are much higher than the national average." Read the following article by Cynthia Washam from Health News Florida, and please contact your elected federal officials and voice your support for Rep. Castor's platform.
Efforts to curb risky and unnecessary cesarean sections have had the added benefit of lowering preterm births nationally for two successive years. But not here in Florida, where C-sections and preterm births continue climbing above the rest of the country.
Castor spearheaded Since the early 1980s, preterm births have risen by a third to more than 12 percent of all births, according to the National Center for Health Statistics. They dipped just slightly between 2006 and 2008.
Here in Florida, the situation is worse. Florida also has a C-section rate of 38 percent, considerably higher than the 32 percent national average.
"If babies are not full term, a few will die," said Dr. Charles Mahan, dean emeritus of the University of South Florida College of Public Health and founder of the college's Lawton and Rhea Chiles Center for Healthy Mothers and Babies. "Many will have respiratory problems, often educational issues, attention-deficit disorder, things like that."
Mahan spoke at the House hearing about the link between elective C-sections and preterm births, and suggested drastic steps to bring both down.
Non-emergency C-sections promote preterm births because doctors try to schedule them before the patient goes into labor, which normally happens between 37 and 42 weeks gestation. The American College of Obstetrics and Gynecology (ACOG) advises members to avoid preterm deliveries by scheduling elective C-sections no sooner than 39 weeks.
ACOG Vice President Dr. Hal Lawrence III testified at the hearing that 96 percent of members follow the guidelines. But a miscalculation in the due date sometimes leads to births at 34 to 37 weeks, or late preterm.
"Seventy-one percent of all preterm births are late preterm," Castor said, "and C-sections account for nearly all the rise in late preterms."
Lori Reeves, Florida's program director for the March of Dimes, believes doctors' interest in avoiding nighttime and weekend deliveries when the patient is in labor leads them to schedule C-sections too early.
"More and more births are scheduled before that 39-week mark," she said. "It's more convenient for doctors to know when the delivery is going to occur."
Physicians once thought a couple days in neonatal intensive care would clear up the often minor breathing and other physical problems associated with late preterm births. But research in the past couple years suggests that many late-preterm youngsters suffer from subtle learning deficits that might not be apparent until they start school.
"Evidence shows that babies born even a couple weeks early do have a high risk of complications," Reeves said. "Some physicians might not have been aware of those risks."
Estimating the due date can be tricky, Mahan explained. Ultrasounds taken around 18 weeks of pregnancy give a good approximation of gestational age, while ultrasounds delayed until later can lead to miscalculations of up to three weeks.
Mahan believes no woman should get a C-section that's not medically necessary, even if she's definitely past 39 weeks. He recommended to the House subcommittee that Medicaid stop paying for all C-sections that are not medically necessary. He called for more vaginal births after cesareans (VBACs).
Although VBACs were common in the 1990s, many doctors and hospitals now consider them too risky to perform. As an incentive, Mahan told the committee insurers should pay physicians $2,000 for VBAC deliveries, $1,500 for vaginal births and only $1,000 for C-sections. Doctors now are paid the most for C-section births.
"The World Health Organization says the (C-section) rate should be 15 percent," Mahan said. "I would say with the obesity epidemic, 20 percent would be reasonable."
To approach that goal, the Florida March of Dimes, Department of Health and University of Florida are sponsoring the Florida Perinatal Quality Collaborative. Their first mission will be to slash the number of elective C-sections before 39 weeks gestation.
"We need to educate moms about their rights during pregnancy and we need to educate doctors to give informed consent," Reeves said.
She expects the program to begin this summer at five hospitals to be chosen. The collaborative will give the hospitals grants and information on how to train physicians to reduce preterm deliveries, and how to collect and assess data.
Physicians who perform elective C-sections will have to provide justification to the hospital. California and a few other states have reduced their C-section rates through similar efforts.
"It's a quality improvement and safety issue," said Mahan, who also is involved with the Collaborative.
Although ACOG and other medical organizations for many years have been calling for fewer C-sections, he believes doctors are ready to listen.
"Now that we're showing doctors this is causing problems, they're backing off," he said. "There's a lot of interest in turning (the preterm rate) around."
Note: Author Cynthia Washam is an independent journalist. Questions and comments about facts from the above article can be sent to Florida Health News Editor Carol Gentry.
Efforts to curb risky and unnecessary cesarean sections have had the added benefit of lowering preterm births nationally for two successive years. But not here in Florida, where C-sections and preterm births continue climbing above the rest of the country.Castor spearheaded Since the early 1980s, preterm births have risen by a third to more than 12 percent of all births, according to the National Center for Health Statistics. They dipped just slightly between 2006 and 2008.
Here in Florida, the situation is worse. Florida also has a C-section rate of 38 percent, considerably higher than the 32 percent national average.
"If babies are not full term, a few will die," said Dr. Charles Mahan, dean emeritus of the University of South Florida College of Public Health and founder of the college's Lawton and Rhea Chiles Center for Healthy Mothers and Babies. "Many will have respiratory problems, often educational issues, attention-deficit disorder, things like that."
Mahan spoke at the House hearing about the link between elective C-sections and preterm births, and suggested drastic steps to bring both down.
Non-emergency C-sections promote preterm births because doctors try to schedule them before the patient goes into labor, which normally happens between 37 and 42 weeks gestation. The American College of Obstetrics and Gynecology (ACOG) advises members to avoid preterm deliveries by scheduling elective C-sections no sooner than 39 weeks.
ACOG Vice President Dr. Hal Lawrence III testified at the hearing that 96 percent of members follow the guidelines. But a miscalculation in the due date sometimes leads to births at 34 to 37 weeks, or late preterm.
"Seventy-one percent of all preterm births are late preterm," Castor said, "and C-sections account for nearly all the rise in late preterms."
Lori Reeves, Florida's program director for the March of Dimes, believes doctors' interest in avoiding nighttime and weekend deliveries when the patient is in labor leads them to schedule C-sections too early.
"More and more births are scheduled before that 39-week mark," she said. "It's more convenient for doctors to know when the delivery is going to occur."
Physicians once thought a couple days in neonatal intensive care would clear up the often minor breathing and other physical problems associated with late preterm births. But research in the past couple years suggests that many late-preterm youngsters suffer from subtle learning deficits that might not be apparent until they start school.
"Evidence shows that babies born even a couple weeks early do have a high risk of complications," Reeves said. "Some physicians might not have been aware of those risks."
Estimating the due date can be tricky, Mahan explained. Ultrasounds taken around 18 weeks of pregnancy give a good approximation of gestational age, while ultrasounds delayed until later can lead to miscalculations of up to three weeks.
Mahan believes no woman should get a C-section that's not medically necessary, even if she's definitely past 39 weeks. He recommended to the House subcommittee that Medicaid stop paying for all C-sections that are not medically necessary. He called for more vaginal births after cesareans (VBACs).
Although VBACs were common in the 1990s, many doctors and hospitals now consider them too risky to perform. As an incentive, Mahan told the committee insurers should pay physicians $2,000 for VBAC deliveries, $1,500 for vaginal births and only $1,000 for C-sections. Doctors now are paid the most for C-section births.
"The World Health Organization says the (C-section) rate should be 15 percent," Mahan said. "I would say with the obesity epidemic, 20 percent would be reasonable."
To approach that goal, the Florida March of Dimes, Department of Health and University of Florida are sponsoring the Florida Perinatal Quality Collaborative. Their first mission will be to slash the number of elective C-sections before 39 weeks gestation.
"We need to educate moms about their rights during pregnancy and we need to educate doctors to give informed consent," Reeves said.
She expects the program to begin this summer at five hospitals to be chosen. The collaborative will give the hospitals grants and information on how to train physicians to reduce preterm deliveries, and how to collect and assess data.
Physicians who perform elective C-sections will have to provide justification to the hospital. California and a few other states have reduced their C-section rates through similar efforts.
"It's a quality improvement and safety issue," said Mahan, who also is involved with the Collaborative.
Although ACOG and other medical organizations for many years have been calling for fewer C-sections, he believes doctors are ready to listen.
"Now that we're showing doctors this is causing problems, they're backing off," he said. "There's a lot of interest in turning (the preterm rate) around."
Note: Author Cynthia Washam is an independent journalist. Questions and comments about facts from the above article can be sent to Florida Health News Editor Carol Gentry.
Friday, May 14, 2010
Postpartum Visitation from SMH Nurses
The new postpartum visitation program at Sarasota Memorial Hospital is gaining much deserved recognition. Watch this home visit and hear nurses Judy Cavallaro and Mary Lewis explain this vitally important program, which is being accepted by almost 100% of new mothers that give birth at SMH.
Tuesday, May 11, 2010
The BABIES Are Coming Saturday!
The Healthy Start Coalition of Sarasota County is collaborating with the Sarasota Film Society to present a special screening of the new documentary Babies. This beautifully filmed documentary depicts 4 babies from Mongolia, Namibia, San Francisco, and Tokyo for the first 18 months of their lives.This special benefit screening begins at 11:00 this Saturday, May 15th, at Sarasota's Burns Court Cinema. Tickets are $10 and include a small popcorn and soda or coffee. Proceeds benefit the Healthy Start Coalition of Sarasota County, a non-profit, 501(c)(3) organization dedicated to improving the health and well-being of pregnant women, infants, and young children. For more information, please visit www.healthystartsarasota.org. A special introduction will be given by Healthy Start Executive Director, Jennifer Highland.
Saturday, May 8, 2010
Response: Ki-Moon's "Making Motherhood Safer"
(Please pardon the sound of the broken record in the background as I type.)
This morning's Herald-Tribune picked up a piece, beautifully written with the best of intentions, in the Opinion pages. The editorial called "Making Motherhood Safer" was penned by Ban Ki-Moon, the Secretary General of the United Nations. Ki-Moon sheds light upon the human rights crisis of women dying in childbirth around the world, in as high a percentage as 1 in 8 in some nations (i.e. Sierra Leone). He describes the struggle to find proper nutrition, the disparity in working hours and income, and the lack of trained attendants. These problems are very real, very scary and must be corrected. I wholeheartedly applaud the actions the United Nations and our own Government have taken, such as the UN Millenium Development Goal 5 and this year's Global Sexual and Reproductive Health Act. There are organizations that are on the ground today (e.g. Bumi Sehat Foundation International, All African People's Development and Empowerment Project) that are actively working to educate and offer women safe and gentle maternal health services. The rates of death in childbirth in these countries is absolutely unacceptable and demands and deserves the utmost priority of every government within the United Nations from which Ki-Moon writes.
However.
Ki-Moon also writes, "We (in the United States) know how to save mothers' lives. Some simple blood tests, a doctor's consultation and someone qualified to help with the birth can make a huge difference. Add some basic antibiotics, blood transfusions and a safe operating room, and the risk of death can almost be eliminated." These things most certainly do save lives in America, and no one doubts that childbirth is safer here than it was over a century ago. But the risk of death is very, very far from being eliminated. On the contrary, it has been steadily increasing since the 1980's, and now there are at least forty--yes, forty--countries in the world that lose fewer mothers than we do, yet we spend more on maternity care (by far) than any other nation in the world.
Sure, mothers in countries like Austria, Greece, Norway, Spain, Sweden, Switzerland, and the United Kingdom fare better than ours do, but so do mothers in Bosnia and Herzegovina, Slovakia, Slovenia, Estonia, Latvia, Lithuania and many more. And this is comparing our rates as a nation (currently 13.3 deaths per 100,000 live births, over three times our Healthy People 2010 goal). If you divide our nation by demographic, the numbers are staggering in places. For example, African American mothers in New York City die eight times more frequently (83.6 deaths per 100,000 live births). Not Sierra Leone, not in Somalia, not in Azerbaijan or Aceh or Haiti or Bangladesh. In New York City.
Why? Why are our rates soaring? Amnesty International has developed a task force to answer this question, and has issued the comprehensive Deadly Delivery: The Maternal Health Care Crisis in the USA. They took their findings to Washington this week in a Congressional Briefing, calling for a Department of Maternal Health under the Health and Human Services umbrella. I strongly support this proposition. We need and must demand accountability for states to accurately report the numbers and causes of maternal deaths (Florida is among the few that require this information on our death certificates). We need and must demand universal prenatal care, appropriate intervention during childbirth, and frequent postpartum visitation. Should a Department of Maternal Health be established, it may as well be subtitled the Office for Homeland Security; for that is the message our government would be sending our mothers. You are safe here. This is America.
This morning's Herald-Tribune picked up a piece, beautifully written with the best of intentions, in the Opinion pages. The editorial called "Making Motherhood Safer" was penned by Ban Ki-Moon, the Secretary General of the United Nations. Ki-Moon sheds light upon the human rights crisis of women dying in childbirth around the world, in as high a percentage as 1 in 8 in some nations (i.e. Sierra Leone). He describes the struggle to find proper nutrition, the disparity in working hours and income, and the lack of trained attendants. These problems are very real, very scary and must be corrected. I wholeheartedly applaud the actions the United Nations and our own Government have taken, such as the UN Millenium Development Goal 5 and this year's Global Sexual and Reproductive Health Act. There are organizations that are on the ground today (e.g. Bumi Sehat Foundation International, All African People's Development and Empowerment Project) that are actively working to educate and offer women safe and gentle maternal health services. The rates of death in childbirth in these countries is absolutely unacceptable and demands and deserves the utmost priority of every government within the United Nations from which Ki-Moon writes.
However.
Ki-Moon also writes, "We (in the United States) know how to save mothers' lives. Some simple blood tests, a doctor's consultation and someone qualified to help with the birth can make a huge difference. Add some basic antibiotics, blood transfusions and a safe operating room, and the risk of death can almost be eliminated." These things most certainly do save lives in America, and no one doubts that childbirth is safer here than it was over a century ago. But the risk of death is very, very far from being eliminated. On the contrary, it has been steadily increasing since the 1980's, and now there are at least forty--yes, forty--countries in the world that lose fewer mothers than we do, yet we spend more on maternity care (by far) than any other nation in the world.
Sure, mothers in countries like Austria, Greece, Norway, Spain, Sweden, Switzerland, and the United Kingdom fare better than ours do, but so do mothers in Bosnia and Herzegovina, Slovakia, Slovenia, Estonia, Latvia, Lithuania and many more. And this is comparing our rates as a nation (currently 13.3 deaths per 100,000 live births, over three times our Healthy People 2010 goal). If you divide our nation by demographic, the numbers are staggering in places. For example, African American mothers in New York City die eight times more frequently (83.6 deaths per 100,000 live births). Not Sierra Leone, not in Somalia, not in Azerbaijan or Aceh or Haiti or Bangladesh. In New York City.
Why? Why are our rates soaring? Amnesty International has developed a task force to answer this question, and has issued the comprehensive Deadly Delivery: The Maternal Health Care Crisis in the USA. They took their findings to Washington this week in a Congressional Briefing, calling for a Department of Maternal Health under the Health and Human Services umbrella. I strongly support this proposition. We need and must demand accountability for states to accurately report the numbers and causes of maternal deaths (Florida is among the few that require this information on our death certificates). We need and must demand universal prenatal care, appropriate intervention during childbirth, and frequent postpartum visitation. Should a Department of Maternal Health be established, it may as well be subtitled the Office for Homeland Security; for that is the message our government would be sending our mothers. You are safe here. This is America.
Wednesday, May 5, 2010
International Day of the Midwife: Re-Introduction to Sarasota's Midwives
Today we celebrate International Day of the Midwife. The following post was published last year on this day. In recognition, I am honored to re-introduce the Licensed Midwives in our community currently practicing in our birth centers, and in your homes.
Christina Holmes, LM, CPM
Christina Holmes is a Licensed Midwife, attending homebirths in Sarasota since 2002, and since 2007 at her own Birthways Family Birth Center. Christina is also a doula, childbirth educator, massage therapist, and mother of three, the youngest of which was born at home with midwife Cathy Matthews, LM. For more information, please visit www.birthwaysfamily.com.
Harmony Miller, LM, CPM
Harmony Miller is a Licensed Midwife, serving Sarasota's families at Rosemary Birthing Home and in their homes since 2006. Harmony has attended midwifery conferences worldwide and continues to learn from the practices of other cultures. In January 2009, she gave birth to Rio at home, with midwife Anne Hirsch, LM. For more information, please visit www.roseemarybirthing.com.
Cathy Matthews, LM
Cathy Matthews is a Licensed Midwife, serving our community for over twenty years. In 2006, she began the Alternative Medicine Program at Everglades University. Cathy is the mother of 5 children, 4 born at home, and 1 grandchild, born at home. For more information please visit www.cathymatthewshomebirth.com.
Alina Vogelhut, LM
Alina Vogelhut is a Licensed Midwife who joined the Rosemary Birthing Home midwifery practice in November 2008. Alina graduated from the Florida School of Traditional Midwifery in Gainesville, and interned for three years at the Birth Cottage in Tallahassee, where she attended nearly 200 births. For more information, please visit www.rosemarybirthing.com.
Christina Holmes, LM, CPMChristina Holmes is a Licensed Midwife, attending homebirths in Sarasota since 2002, and since 2007 at her own Birthways Family Birth Center. Christina is also a doula, childbirth educator, massage therapist, and mother of three, the youngest of which was born at home with midwife Cathy Matthews, LM. For more information, please visit www.birthwaysfamily.com.
Harmony Miller, LM, CPMHarmony Miller is a Licensed Midwife, serving Sarasota's families at Rosemary Birthing Home and in their homes since 2006. Harmony has attended midwifery conferences worldwide and continues to learn from the practices of other cultures. In January 2009, she gave birth to Rio at home, with midwife Anne Hirsch, LM. For more information, please visit www.roseemarybirthing.com.
Cathy Matthews, LMCathy Matthews is a Licensed Midwife, serving our community for over twenty years. In 2006, she began the Alternative Medicine Program at Everglades University. Cathy is the mother of 5 children, 4 born at home, and 1 grandchild, born at home. For more information please visit www.cathymatthewshomebirth.com.
Alina Vogelhut, LMAlina Vogelhut is a Licensed Midwife who joined the Rosemary Birthing Home midwifery practice in November 2008. Alina graduated from the Florida School of Traditional Midwifery in Gainesville, and interned for three years at the Birth Cottage in Tallahassee, where she attended nearly 200 births. For more information, please visit www.rosemarybirthing.com.
Monday, May 3, 2010
Congressional Briefing on Maternal Health May 6
Dear Senator George LeMieux, Senator Bill Nelson and Congressman Vern Buchanan:
I am writing to invite you to a Congressional briefing taking place this week that will focus on an issue about which I care deeply: the right to maternal health. The briefing takes place this Thursday, May 6th from 12pm to 2pm in the Rayburn House Office Building, Room 2226. Representatives John Conyers, Lois Capps and Gwen Moore will be participants in this long overdue conversation, hosted by Amnesty International in light of their recent report "Deadly Delivery: The Maternal Health Care Crisis in the USA."
You have heard the statistic that the United States spends more than any other country on health care, but did you know that we rank a shameful 41st in the world in maternal mortality? Women in 40 other countries die less frequently from complications of pregnancy or childbirth. African American women are nearly four times as likely to die, and other communities of color are also disproportionately affected by barriers to maternal health.
In honor of Mother's Day, Amnesty International will gather with U.S. and international maternal health advocates in Washington Thursday to underscore the U.S. government’s crucial role in fulfilling the right to maternal health at home and abroad. I appreciate and encourage your attendance in this important discussion of human rights, and look forward to your timely response.
Sincerely,
Laura Gilkey, mother of two, Sarasota, Florida
Vice President, Florida Friends of Midwives
Informed Consent Subcomittee, Coalition for Improving Maternity Services
Planning and Evaluation Committee, Healthy Start Coalition of Sarasota County
CONGRESSIONAL BRIEFING DETAILS
Thursday, May 6, 2010, 12 noon to 2 p.m. Rayburn House Office Building, Room 2226.
Lunch will be served. RSVP appreciated, but not required, to Jason Opeña Disterhoft at jdisterhoft@aiusa.org or 212-633-4292. Please contact Jason for more information about the event.
Remarks by:
Chairman John Conyers, Jr. - Democrat of Michigan
Representative Lois Capps* - Democrat of California
Representative Gwen Moore - Democrat of Wisconsin
Larry Cox - Amnesty International USA – Executive Director
Hilary Shelton - NAACP – Director, Washington Bureau and Senior Vice President for Advocacy and Policy
Maureen Corry - Childbirth Connection – Executive Director
Featured Panelists:
Jennie Joseph - Midwife and activist from Florida
Nan Strauss - Amnesty International USA – Researcher
Clare Johnson - Family member
Betsy McCallon - White Ribbon Alliance Global Secretariat - Deputy Director
*Invited
I am writing to invite you to a Congressional briefing taking place this week that will focus on an issue about which I care deeply: the right to maternal health. The briefing takes place this Thursday, May 6th from 12pm to 2pm in the Rayburn House Office Building, Room 2226. Representatives John Conyers, Lois Capps and Gwen Moore will be participants in this long overdue conversation, hosted by Amnesty International in light of their recent report "Deadly Delivery: The Maternal Health Care Crisis in the USA."
You have heard the statistic that the United States spends more than any other country on health care, but did you know that we rank a shameful 41st in the world in maternal mortality? Women in 40 other countries die less frequently from complications of pregnancy or childbirth. African American women are nearly four times as likely to die, and other communities of color are also disproportionately affected by barriers to maternal health.
In honor of Mother's Day, Amnesty International will gather with U.S. and international maternal health advocates in Washington Thursday to underscore the U.S. government’s crucial role in fulfilling the right to maternal health at home and abroad. I appreciate and encourage your attendance in this important discussion of human rights, and look forward to your timely response.
Sincerely,
Laura Gilkey, mother of two, Sarasota, Florida
Vice President, Florida Friends of Midwives
Informed Consent Subcomittee, Coalition for Improving Maternity Services
Planning and Evaluation Committee, Healthy Start Coalition of Sarasota County
CONGRESSIONAL BRIEFING DETAILS
Thursday, May 6, 2010, 12 noon to 2 p.m. Rayburn House Office Building, Room 2226.
Lunch will be served. RSVP appreciated, but not required, to Jason Opeña Disterhoft at jdisterhoft@aiusa.org or 212-633-4292. Please contact Jason for more information about the event.
Remarks by:
Chairman John Conyers, Jr. - Democrat of Michigan
Representative Lois Capps* - Democrat of California
Representative Gwen Moore - Democrat of Wisconsin
Larry Cox - Amnesty International USA – Executive Director
Hilary Shelton - NAACP – Director, Washington Bureau and Senior Vice President for Advocacy and Policy
Maureen Corry - Childbirth Connection – Executive Director
Featured Panelists:
Jennie Joseph - Midwife and activist from Florida
Nan Strauss - Amnesty International USA – Researcher
Clare Johnson - Family member
Betsy McCallon - White Ribbon Alliance Global Secretariat - Deputy Director
*Invited
Sunday, May 2, 2010
International Day of the Midwife
May 5th is the International Day of the Midwife, a day set aside in 1991 by the International Confederation of Midwives and observed in over 50 nations worldwide. A 24-hour virtual event in honor of the day is being held here. In 1992, Florida Governor Lawton Chiles joined in this celebration by adding Florida to the growing list of states and countries that observe this day.
The World Health Organization states: “On the International Day of the Midwife, we pay tribute to the work of the midwives who are key healthcare providers in facilities and communities. They provide the high‐quality and cost‐effective package of care desperately needed by millions of women around the world. The World Health Organization recognizes the contribution of midwives to the reduction of maternal and newborn mortality and renews its support to quality midwifery!”
Florida Friends of Midwives will honor of this day in Sarasota on May 6th (5:30 pm, Selby Public Library Auditorium) with an exclusive screening of Guerrilla Midwife, a documentary recently showcased at the Sarasota Film Festival. The film follows midwife Robin Lim along the streets of Bali and into the Acehnese refugee camps of Indonesia, where the midwifery model of care is put to the test, at the epicenter of the turmoil following the 2004 tsunami.
No stranger to the international disparity in childbirth practice, Orlando Licensed Midwife Jennie Joseph was the first foreign-trained midwife to be licensed under the Midwifery Practice Act in Florida in 1994. “I trained as a midwife in England 31 years ago and graduated in May of 1981 with the knowledge that midwifery was the 'gold standard' of care for women worldwide,” says Joseph. “Imagine my surprise on arriving in the US in 1989, where I quickly discovered a total lack of interest, understanding or even acknowledgment of the importance of midwives for a nations health.”
Ms. Joseph is executive director of The Birth Place, a free-standing birthing facility in Winter Garden, and the developer of The JJ WAY, a Maternal Child Healthcare delivery model for indigent women. “Today, I begin to have hope that American's are opening up to the benefits of midwifery in matters of choice, safety, empowerment and economy; that we realize that the midwifery model of care can be the vehicle that moves us higher up on the list of countries providing exemplary maternity care for it's citizens, and that truly 'a midwife for every mother' is not an impossible dream,” says Joseph. “A heartfelt thank you to all the midwives - past, present and future and Happy International Midwives Day!”
Midwives have a long and valued history in Florida. The state first passed legislation to license direct-entry midwives in 1931, and the first Certified Nurse Midwife was licensed in Florida in 1970. Florida’s midwives have continued to tirelessly serve the families of Florida and to ensure the continued availability of safe, evidence-based birthing options for Florida’s families.
About Florida Friends of Midwives: Florida Friends of Midwives is a non-profit grassroots organization dedicated to promoting the Midwives Model of Care and supporting the practice of midwifery in Florida. Florida Friends of Midwives was formed to support midwives who offer safe, cost-effective, evidence based care to Florida's families. For more information, please visit www.flmidwifery.org.
The World Health Organization states: “On the International Day of the Midwife, we pay tribute to the work of the midwives who are key healthcare providers in facilities and communities. They provide the high‐quality and cost‐effective package of care desperately needed by millions of women around the world. The World Health Organization recognizes the contribution of midwives to the reduction of maternal and newborn mortality and renews its support to quality midwifery!”
Florida Friends of Midwives will honor of this day in Sarasota on May 6th (5:30 pm, Selby Public Library Auditorium) with an exclusive screening of Guerrilla Midwife, a documentary recently showcased at the Sarasota Film Festival. The film follows midwife Robin Lim along the streets of Bali and into the Acehnese refugee camps of Indonesia, where the midwifery model of care is put to the test, at the epicenter of the turmoil following the 2004 tsunami.No stranger to the international disparity in childbirth practice, Orlando Licensed Midwife Jennie Joseph was the first foreign-trained midwife to be licensed under the Midwifery Practice Act in Florida in 1994. “I trained as a midwife in England 31 years ago and graduated in May of 1981 with the knowledge that midwifery was the 'gold standard' of care for women worldwide,” says Joseph. “Imagine my surprise on arriving in the US in 1989, where I quickly discovered a total lack of interest, understanding or even acknowledgment of the importance of midwives for a nations health.”
Ms. Joseph is executive director of The Birth Place, a free-standing birthing facility in Winter Garden, and the developer of The JJ WAY, a Maternal Child Healthcare delivery model for indigent women. “Today, I begin to have hope that American's are opening up to the benefits of midwifery in matters of choice, safety, empowerment and economy; that we realize that the midwifery model of care can be the vehicle that moves us higher up on the list of countries providing exemplary maternity care for it's citizens, and that truly 'a midwife for every mother' is not an impossible dream,” says Joseph. “A heartfelt thank you to all the midwives - past, present and future and Happy International Midwives Day!”Midwives have a long and valued history in Florida. The state first passed legislation to license direct-entry midwives in 1931, and the first Certified Nurse Midwife was licensed in Florida in 1970. Florida’s midwives have continued to tirelessly serve the families of Florida and to ensure the continued availability of safe, evidence-based birthing options for Florida’s families.
About Florida Friends of Midwives: Florida Friends of Midwives is a non-profit grassroots organization dedicated to promoting the Midwives Model of Care and supporting the practice of midwifery in Florida. Florida Friends of Midwives was formed to support midwives who offer safe, cost-effective, evidence based care to Florida's families. For more information, please visit www.flmidwifery.org.
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